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Descriptions of Impaired Defenses
Based on their study of dynamic interviews, Sylvie Berney and her colleagues (2014) identified 6 psychotic defense mechanisms and created a scale to assess these defenses.
The authors note that the concept psychotic is used in different ways thus they clarify that they are not referring to symptoms or diagnoses. Instead, psychotic defense mechanisms refer to the way people respond to a stressor. Clinicians attempt to determine how the defense strategy functions.
Following are descriptions of the 6 psychotic
defense mechanisms. If using the hierarchical approach, the 6 psychotic
mechanisms would be considered level 0.
Autistic Withdrawal
Autistic Withdrawal is a response to a stressor usually
evident in losing contact with reality. They have become nonresponsive and have
lost touch with their environment.
Concretization
Concretization is a response to a stressor
characterized by representing a stressor in a concrete form such as an object
or an action. For example, feeling very anxious about others knowing personal
details and stealing identity may be concretized by reference to WiFi routers
or fear of being poisoned may be concretized in terms of items in a
refrigerator.
Delusional Projection
Delusional Projection is a response to a stressor characterized
by attributing personal needs and attitudes to another source (an external
object such as other people) but the descriptions of the targeted people or
objects is delusional.
Distortion
Distortion is a response to a stressor characterized
by reframing internal or external reality. Distortion may be evident in a
changed mood state (elevated or depressed) in response to the altered reality.
Distortion may also be evident in the way a person describes reality, which
reflects the way they have structured reality.
Fragmentation
Fragmentation is a response to a stressor
characterized by splitting reality such that it is fragmented and disorganized.
The person’s communication is confusing and difficult to follow.
Psychotic Denial
Psychotic Denial is a response to a stressor that
fails to acknowledge a feature of their experience of reality or a feature of
observable reality such as a life event or an object. This defense is
fundamental to understanding psychotic defense mechanisms.
Reference
Berney, S., Roten, Y., Beretta, V., Kramer, U., & Despland, J. (2014). Identifying psychotic defenses in a clinical interview. Journal of Clinical Psychology, 70(5), 428–439. https://doi.org/10.1002/jclp.22087
Related Posts
Psychology of Defense Mechanisms
Geoffrey W. Sutton, PhD is Emeritus Professor of Psychology. He
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